Care Sector Warns Earned Settlement Plans Could Deepen Workforce Crisis
Adult social care organisations and migrant health and care workers are warning that proposed changes to the UK’s settlement system could place further pressure on an already stretched workforce and undermine efforts to improve recruitment and retention.
A coalition of organisations representing the care sector, healthcare professionals, racial equality campaigners and migrants’ rights groups is due to raise its concerns with MPs at Westminster on Monday 14 September, ahead of the Government’s expected implementation of its proposed “Earned Settlement” reforms later this year.
What the changes mean for care workers
The proposals, published by Home Secretary Shabana Mahmood in November 2025, would overhaul the route to settlement for around two million people currently living and working in the UK. Under the Earned Settlement model, the standard qualifying period for ILR would double from five to ten years for most migrants — but care workers and other “low and medium skilled professionals” would face a harsher 15-year baseline. Refugees would face a 20-year wait.
Additional penalties would apply to anyone who had received benefits, entered on a visitor visa, or overstayed at any point — while higher earners would be offered a faster route. The changes would apply retrospectively to everyone in the UK who has not yet obtained ILR, and would come alongside longer periods of work restrictions, exclusion from public funds, and higher visa fees.
A public consultation on the proposals closed in February, but the Government has yet to publish either its response or an impact assessment. Ministers are expected to begin implementing the changes this autumn under Prime Minister Andy Burnham.
Sector leaders sound the alarm
With international recruitment having propped up a workforce depleted by falling numbers of British-born staff, sector leaders argue the proposals could not come at a worse time.
Jane Townson of the Homecare Association pointed out that workers without UK or EU nationality make up 30% of the homecare workforce, and that international recruitment has been essential to sustaining service levels since 2020, as the number of British nationals in the care workforce has fallen sharply. She called on the Government to reform commissioning practices, make it easier for care workers to settle, and allow more flexible visa arrangements.
Professor Martin Green of Care England said the Prime Minister had made social care central to his premiership and that hope had begun to return to the sector — but warned that continuing with the proposals risked that hope “curdling into the same disillusionment care workers have felt for a decade.”
Karolina Gerlich of the Care Workers’ Charity said a 15-year wait for settlement asked more of care staff than of any other profession, at precisely the moment the sector most needs to retain experienced workers, and called on the Prime Minister to use the opportunity to change course on adult social care.
A warning from radiography and the wider NHS
The impact would be felt well beyond social care. Dean Rogers of the Society of Radiographers said radiography has faced a long-standing workforce crisis, with internationally trained staff now making up almost a third of registered diagnostic radiographers, and pointed to Health and Care Professions Council data showing the number of internationally trained registrants working in the UK had already fallen by more than 600 — a 12% drop — between May 2025 and May 2026.
Echoes of Windrush
Organisers argue the parallels with the Windrush scandal are direct: many of those set to be affected came to the UK during the COVID-19 pandemic to work in health and social care, in much the same way the Windrush generation answered the call to help build the NHS.
Kimberly McIntosh of Action for Race Equality said the Windrush Lessons Learned Review had been clear that immigration policy should not change without a rigorous impact assessment and proper consideration of the risk of harm to racialised communities — an assessment that has still not been published for the Earned Settlement proposals, despite their likely disproportionate impact on Black and Asian communities.
Bell Ribeiro-Addy MP said the legacy of the Windrush scandal “lives on through policy proposals like Earned Settlement,” warning that recruitment and retention in health and social care are already declining and that many staff are now reconsidering their future in the UK.
